Our feet are very complicated. We have numerous bones, muscles, tendons, ligaments and numerous joints which all play a role in the orchestra of proper foot function. Unfortunately, these structures don’t always cooperate. Foot injury and foot pain is very common. One cause of pain in the foot is cuboid syndrome.
The Cuboid is a bone located in the outer aspect of the foot, approximately half-way between the heel and the end of the baby toe. For some reason, this bone in particular can become irritated and painful, including the joint structures around it. The pain can be caused by a traumatic injury, or can be related to dysfunction after overuse, such as with running. Usually, pain will be present with weight bearing and can be aggravated with excessive force through the bottom of the foot (as in jumping and running). The diagnosis of cuboid syndrome is rather subjective, as the practitioner will often appreciate the bone feeling malpositioned. The area may be tender to touch and movement of the surrounding bones may be painful in the cuboid. Boney pathology (including fracture) and joint sprain are other possibilities that the clinician may need to rule out. X-rays can be sometimes helpful in this process.
The treatment for cuboid syndrome can vary and depends on the presentation of each individual patient. For example, chronic cases of cuboid syndrome that are not particularly sensitive may benefit from a cuboid adjustment or mobilization of the joint. This is performed with the patient lying on their stomach with the practitioner performing a controlled thrust to the bottom of the foot in the area of the cuboid. Some patients may not be candidates for this type of treatment. If their foot is swollen or particularly painful, modalities like laser and acupuncture might be a more appropriate way to heal the area without running the risk of aggravating the tissue.
Keep in mind that cuboid syndrome is one of many possible diagnosis’ for the lateral aspect of the foot. Unsure if you may have cuboid syndrome? Give us a call, we can help you “heel” your injuries. Ahem…
Matthews MLG & Claus AP. Two examples of ‘cuboid syndrome’ with active bony pathology: why did manual therapy help? Manual Therapy 2014; 19(5): 494-8.